新生儿重症监护病房中低出生体重儿嗜酸性粒细胞增多危险因素分析

Risk factors for eosinophilia in low-birth-weight infants in NICU

目的分析新生儿重症监护病房(NICU)中低出生体重儿嗜酸性粒细胞增多的危险因素。方法回顾性分析2019年1月1日至2020年3月31日在北京大学第三医院儿科NICU住院的496例低出生体重儿的病例资料,因各种原因剔除196例,根据嗜酸性粒细胞是否增多分为嗜酸性粒细胞增多组和对照组,各150例。通过单因素分析进行筛选,再通过非条件Logistic回归分析低出生体重儿嗜酸性粒细胞增多的影响因素。结果 (1)两组患儿嗜酸性粒细胞均在生后第3周达到高峰,然后逐渐下降,嗜酸性粒细胞增多组嗜酸性粒细胞升高持续时间更长。(2)母亲有妊娠期高血压、胎膜早破、儿童出生后患食物过敏、感染、贫血、输血、支气管肺发育不良(BPD)、白细胞增多、血小板增多在两组患儿分别为59例(39.3%)、33例(22.0%);47例(31.3%)、31例(20.7%);10例(6.7%)、1例(0.7%);54例(36.0%)、15例(10.0%);133例(88.7%)、88例(58.7%);67例(44.7%)、26例(17.3%);75例(50.0%)、23例(15.3%);61例(40.6%)、43例(28.7%);54例(36.0%)、32例(21.3%),差异有统计学意义(χ^(2)=10.598、4.435、7.644、28.628、34.796、26.196、40.978、11.092、7.890;P=0.001、0.035、0.006、0.000、0.000、0.000、0.000、0.001、0.005);两组患儿出生胎龄分别为30.00周、31.43周,出生体重分别为1280.0g、1550.0g,差异有统计学意义(Z=-4.933、-6.220,χ^(2)=0.000、0.000)。(3)非条件Logistic回归分析显示母亲患妊娠期高血压、儿童出生后患感染、BPD、食物过敏、贫血、血小板增多是低出生体重儿嗜酸性粒细胞增多的影响因素(OR=2.190、2.442、3.441、9.241、2.757、2.190;95%CI=1.202~3.989、1.199~4.891、1.841~6.433、1.095~78.018、1.395~5.447、1.202~.989)。结论母亲患妊娠期高血压、儿童出生后患感染、BPD、食物过敏、贫血、血小板增多是低出生体重儿外周血嗜酸性粒细胞升高的危险因素。

Objective To analyze the factors influencing eosinophilia in low birth weight infants in NICU. Methods The clinical data of 496 cases of low-birth-weight infant in NICU of Peking University Third Hospital from January 1,2019 to March 31,2020 were analyzed retrospectively. A total of 196 cases were excluded for various reasons. Three hundreds of cases were divide into eosinophilia group( 150 cases) and control group( 150 cases) according to whether eosinophilia was present or not.The data were identified by univariate analysis,and followed by unconditional logistic regression analysis of factors influencing eosinophilia in low-birth-weight infants.Results( 1) Eosinophils in both groups peaked in the third week after birth and then gradually declined,but a longer duration of eosinophilia was shown in the eosinophilia group.( 2) The case number of mothers with gestational hypertension,premature rupture of membranes,postnatal food allergy,infection,anemia,blood transfusion,BPD,leukocytosis and thrombocytosis in both groups was respectively 59( 39.3%) vs.33( 22.0%),47( 31.3%) vs.31( 20.7%),10( 6.7%) vs.1( 0.7%),54( 36.0%) vs.15( 10.0%),133( 88.7%) vs. 88( 58. 7%),67( 44. 7%) vs. 26( 17. 3%),75( 50.0%) vs.23( 15.3%),61( 40.6%) vs.43( 28. 7%),and54( 36. 0%) vs. 32( 21. 3%),the difference being statistically significant( χ^(2)= 10. 598,4. 435,7. 644,28. 628,34.796,26. 196,40.978,11.092,7.890;P = 0.001,0.035,0.006,0.000,0.000,0.000,0.000,0.001,0.005). In the two groups. the gestational age at birth was 30.00 and 31.43 weeks and the birth weight was 1280.0 g and 1550.0 g,respectively,and the difference was statistically significant( Z =-4.933,-6.220,χ^(2)= 0.000,0.000).( 3) Unconditional logistic regression analysis showed that mothers’ gestational hypertension,postnatal infection of infants,BPD,food allergy,anemia and thrombocytosis were influencing factors of eosinophilia in low-birth-weight infants( OR = 2. 190,2. 442,3. 441,9. 241,2. 757,2. 190;95% CI = 1. 202-3.989,1.199-4.891,1.841-6.433,1.095-78.018,1.395-5.447,1.202-3.989).Conclusion Mothers’ gestational hypertension,postnatal infection of infants,BPD,food allergy,anemia and thrombocytosis are influencing factors of eosinophilia in low-birth-weight infants.